Mupirocin Prescribing Guidelines for Nasal Cuts

Indications and Contraindications

• The Infectious Diseases Society of America recommends mupirocin nasal decolonization only for recurrent skin and soft tissue infections despite optimized hygiene measures, or ongoing household transmission of MRSA—not for recurrent trauma 3, 4
• Simple nasal cuts without signs of infection do not meet criteria for antimicrobial therapy, as stated by the Clinical Infectious Diseases guidelines 1, 2

Decolonization Protocols

• Decolonization with intranasal mupirocin twice daily for 5-10 days is reserved for patients with documented recurrent staphylococcal infections, according to the Infectious Diseases Society of America 3, 4
• The standard decolonization regimen is mupirocin 2% ointment to anterior nares twice daily for 5-10 days, as recommended by the Clinical Infectious Diseases guidelines 3, 4

Alternative Management Strategies

• Recurrent nasal cuts suggest mechanical trauma or underlying dermatologic conditions that require non-antimicrobial management, such as nasal saline spray or gel to maintain mucosal moisture, as suggested by the Clinical Infectious Diseases guidelines 1, 2
• If there is concern for underlying conditions, these should be evaluated and treated directly rather than with antimicrobials, according to the Clinical Infectious Diseases guidelines 1, 2, 5

Appropriate Use of Mupirocin

• If the patient develops signs of actual infection, then culture the wound and treat with appropriate antimicrobials based on clinical presentation, as recommended by the Clinical Infectious Diseases guidelines 1, 2
• If the patient has documented recurrent staphylococcal skin infections, then consider decolonization with mupirocin twice daily for 5-10 days combined with hygiene measures, according to the Infectious Diseases Society of America guidelines 3, 4